Normal Physiology Clinical Trial
Official title:
The Effect of Transcranial Magnetic Stimulation on Learning With Reward in Healthy Humans
Background:
- Two areas on the surface of the brain, the dorsolateral prefrontal cortex (DLPFC) and motor
cortex (MC), play a key role during learning. Researchers are interested in determining the
effect that transcranial magnetic stimulation (TMS) on the DLPFC and MC has on participants'
performance of learning tasks. By studying the effect of TMS on reaction time, learning, and
memory, researchers hope to better understand how to treat conditions such as Parkinson's
disease and traumatic brain injury that affect these parts of the brain.
Objectives:
- To study the effects of transcranial magnetic stimulation on the dorsolateral prefrontal
cortex and motor cortex.
- To learn which areas of the brain are used to perform certain learning and memory tasks.
Eligibility:
- Healthy, right-handed individuals between 18 and 70 years of age.
Design:
- Participants will be screened with a physical and neurological examination and a medical
and psychiatric history.
- Participants will be asked to take part in one of five different parts of this study.
Most participants will have four 2-hour visits to the National Institutes of Health
Clinical Center. Some participants (those involved in Part 5) will have only one 2-hour
visit.
- Parts 1 and 2 (four visits): Participants will have TMS, and then do a learning task
that may provide a small monetary reward. On the first visit, before the TMS,
participants will take an intelligence test based on reading aloud the words given on a
card. Participants who have not had a routine magnetic resonance imaging (MRI) scan of
the brain within the past year will also have a scan.
- Parts 3 and 4 (four visits): Participants will have a functional MRI scan while doing a
learning task that may provide a small monetary reward. On the first visit, before the
functional MRI, participants will take an intelligence test based on reading aloud the
words given on a card. Participants who have not had a routine magnetic resonance
imaging (MRI) scan of the brain within the past year will also have a scan.
- Part 5 (one visit): Participants will take an intelligence test based on reading aloud
the words given on a card. Then, participants will have TMS followed by a functional MRI
scan. During the functional MRI, participants will do a button-pressing task that may
provide a small monetary reward.
- Participants will also be asked to provide a small blood sample for genetic analysis.
Objective
Theta burst transcranial magnetic stimulation (TBS) produces functional changes in human
motor cortex. Continuous inhibitory TBS, (cTBS) over the primary motor cortex (M1) produces a
temporary impairment of learning in healthy individuals similar to that seen in patients with
traumatic brain injury (TBI) and Parkinson disease (PD). The depression of learning by cTBS
may serve as a model for learning and memory deficits in these disorders and provide a means
of screening treatments for efficacy and exploring their mechanisms. Our immediate goal is to
see whether manipulation of the behavioral contingencies of the task, particularly adding
reward, will overcome the virtual lesion produced by cTBS.
The first aim of the project is to examine inhibitory effects of cTBS on implicit (serial
reaction time /SRT) and explicit (trial-and-error) motor learning of a sequence of target
locations.
The second aim of the project is to examine the effects of cTBS on non-motor implicit and
explicit probabilistic classification learning using the weather prediction task (WPT). We
will investigate the involvement of M1 and dorsolateral prefrontal cortex (DLPFC) in implicit
and explicit learning by studying participants who will perform these tasks following cTBS
over: 1) M1, 2) DLPFC and 3) sham TBS.
Our third aim is to examine the effect of manipulating reward during implicit and explicit
learning following inhibitory TBS over M1 and DLPFC as it is possible that learning deficits
caused by TBS can be improved by increasing the amount of reinforcement during learning.
Our fourth aim is to examine the neural networks underlying implicit and explicit learning
with and without reward by studying participants who will perform these tasks during
functional MRI (fMRI). Finally, we will also perform fMRI during implicit sequence learning
and after cTBS over M1 to identify its effects on the neural networks involved in implicit
learning.
Study population
Healthy volunteers (n = 272, aged 18 70), without any contraindication to TBS or MRI. This
number includes 60 participants each for Experiments 1 and 2, 24 participants each for
Experiments 3-5. In addition, 35 participants are included for piloting behavioral and
imaging procedures. In order to account for potential dropouts and withdrawals (up to 20%),
the total accrual ceiling includes a further 45 participants to equal 272.
Design
The study contains five, mixed or crossover design experiments with appropriate controls to
eliminate order effects.
Outcome measures
We will examine the effects of reward and TBS and their interaction on measures of learning.
Secondary outcome measures will be how TBS and reward interact to alter the pattern of BOLD
activation on MRI and the effects of relevant genetic variation on learning variables and
BOLD activation. We will examine the effects of genetic variations in relevant genes on these
outcomes.
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